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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state and described in 42 CFR 435.119.
Summary: This amendment updates the State Plan to indicate that prior quarter coverage will be covered for all Title XIX populations effective on January 1, 2014.
Summary: Proposes that one or more Qualified Hospitals Determine Presumptive Eligibility and WV Provides Medicaid Coverage for Individuals Determined Presumptively Eligible.
Summary: Incorporates the residency requirements at 42 Code of Federal Regulations Section 435.403 into the West Virginia Medicaid State Plan in accordance with the Affordable Care Act.
Summary: This amendment provides that, effective from October 1 2013 to September 30 2014 inpatient hospital services will continue to be paid at the rate in effect as of September 30 2011 reduced by five percent.
